To the ER or not?

ghphotog

My DW has an abscess just outside of her private part, I know I can just say it but the contract doctor says that if antibiotics don't work in a couple of days she needs to go to the ER. God I hope not. Waiting hours in the ER with an advanced Alzheimer's wife in full incontinence and hysterics is not something I want to do.

Should I insist they try antibiotics longer than two days and deny ER visits? Maybe time for a hospice eval and let this thing heal on its own or run it's course?

M1

Oh what a tough one. The general treatment for abscesses is surgical, they usually have to be drained. It may drain spontaneously—that would be ideal.

Honestly I would opt for hospice and conservative treatment, though realizing that this is serious enough to be an end of life event, it could definitely take her life if she becomes septic. Does she seem to be in a lot of discomfort, or not? If she's not in a lot of pain, I would keep her at MC. I'm so sorry, that's a really tough call.

ghphotog

M1, I have a hospice evaluation in the works.

ghphotog

She seems to only be in pain when they have to wipe her.

Jgirl57

oh my! These are the tough decisions I dread . So sorry to hear this . I hope the hospice evaluation gives you some direction . Note to M1: Thank you for always giving great straight forward guidance.

Anna2022

https://alzconnected.org/discussion/comment/218447#Comment_218447

Thank you, M1, for always being straightforward and kind. Many, many thanks.

M1

Least i can do. Gotta be uncomfortable, it's going to be very difficult to heal regardless because of the incontinence. I'd have a very low threshold to give her morphine and keep her comfortable. such things that would be easily treatable in anyone else are life threatening here. Perhaps it helps to look at it as almost inevitable in this setting: something is going to take her, and here it is. Treating it aggressively does what? Prolongs her agony? Im so sorry.

Iris L.

This sounds like a Bartholin's gland cyst that got infected. It can be treated with sitz baths, possibly oral antibiotics. You might ask a gyn doctor or wound care nurse about a topical ointment to apply for pain management.

Iris

ghphotog

Just finished the hospice eval and I'm so much more impressed with this company versus my mom's.
The hospice physician asked a lot of questions and did an exam. They will continue to treat the abcess with anitibotics and warm compresses. She did change my wife's diagnosis based on her history of symptoms to Diffussed Lewey Body dementia. She really knew a lot about dementia and what type of anxiety meds work best so she took her off of her current meds because they can increase agitation and anxiety and put her on better meds. I'm so impressed so far.

jfkoc

Not all Hospices are created equal.. Finger crossed for your mothers current treatment. Please keep us updated.

Jgirl57

ghphotog, that is good news. May help her be more comfortable . It sounds like the hospice evaluation gave you some comfort

M1

That's great. Better to call to early than too late and this is proof why…..

fmb

That is very good news!